﻿<%@ page language="java" contentType="text/html; charset=UTF-8" pageEncoding="UTF-8"%>
<%@ taglib prefix="c" uri="http://java.sun.com/jsp/jstl/core"%>
<%@ taglib prefix="fmt" uri="http://java.sun.com/jsp/jstl/fmt"%>

<div class="modal-dialog x-modal-dialog" style="width: 650px; margin-top: 100px;">
  <div class="modal-content">

    <div class="modal-header">
      <button type="button" class="close" data-dismiss="modal">
        <span aria-hidden="true">&times;</span><span class="sr-only">Close</span>
      </button>
      <h4 class="modal-title">Assessor&nbsp;-&nbsp;Search</h4>
    </div>

    <form class="form-horizontal" role="form" method="GET" action="${ctx.host}/assessors" data-validate="true">

      <input type="hidden" name="filter" value="true">

      <div class="modal-body">

        <div class="form-group ms-form-group =">
          <label class="col-xs-4 control-label">Name</label>
          <div class="col-xs-6 pull-left">
            <input type="text" class="form-control" name="name" placeholder="name" />
          </div>
        </div>

        <div class="form-group ms-form-group">
          <label class="col-xs-4 control-label">Email Address</label>
          <div class="col-xs-6 pull-left">
            <input type="text" class="form-control" name="email" placeholder="Email Address" />
          </div>
        </div>

        <div class="form-group ms-form-group">
          <label class="col-xs-4 control-label">Telephone</label>
          <div class="col-xs-6 pull-left">
            <input type="text" class="form-control" name="telephone" placeholder="Telephone" />
          </div>
        </div>

        <div class="form-group ms-form-group">
          <label class="col-xs-4 control-label">Mobile</label>
          <div class="col-xs-6 pull-left">
            <input type="text" class="form-control" name="mobile" placeholder="Mobile" />
          </div>
        </div>

        <div class="form-group x-form-group payment-type">
          <label class="col-xs-4 control-label">Hotel Name</label>
          <div class="col-xs-6 pull-left">
            <input type="text" class="form-control" name="hotelName" placeholder="Hotel Name" />
          </div>
        </div>

        <div class="form-group x-form-group payment-type">
          <label class="col-xs-4 control-label">Subregion</label>
          <div class="col-xs-6 pull-left">
            <input type="text" class="form-control" name="subregion" placeholder="Subregion" />
          </div>
        </div>

        <div class="form-group ms-form-group">
          <label class="col-xs-4 control-label">Title</label>
          <div class="col-xs-6 pull-left">
            <input type="text" class="form-control" name="title" placeholder="Title" />
          </div>
        </div>
      </div>

      <div class="modal-footer" style="text-align: center">
        <button type="submit" class="btn btn-success btn-shadow btn-shadow-success x-btn">Submit</button>
        <button type="button" class="btn btn-default btn-shadow btn-shadow-default x-btn" data-dismiss="modal">Cancel</button>
      </div>

    </form>
  </div>

</div>
